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Women and Heartburn

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Updated September 20, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

When all things are equal, such as lifestyle habits and diets, woman do not appear to suffer from heartburn more frequently than men. The difference comes when woman are going through conditions men never will experience. One of these is pregnancy. For many women, their first episode of heartburn will occur during pregnancy. In fact, statistics have shown that more than half of all pregnant women will suffer from heartburn. There are steps, however, that women can take to minimize heartburn during pregnancy.

Heartburn during pregnancy occurs for a number of reasons. Increased levels of hormones in your body while pregnant can soften the ligaments that normally keep the lower esophageal sphincter (LES) tightly closed. If the LES relaxes at inappropriate times, food and stomach acids can reflux back up into your esophagus and throat. Also more pressure is put on your stomach as your body changes and your baby grows. This, in turn, can force stomach contents through the LES and into your esophagus.

For some women, taking progesterone can cause heartburn. Progesterone is a hormone secreted by the ovaries which affect many aspects of the female body, including regulating menstrual cycles and in pregnancy. Progesterone can also enhance mood, help protect against certain cancers (e.g. endometrial cancer), and reduce or stop bone loss (osteoporosis). Progesterone has also been used in the treatment of some postmenopausal women.

In addition to pregnancy and progesterone, there are other factors that can cause heartburn in women (and men). These include:

Being Overweight

Research has shown that being overweight, especially around your middle, can increase your chance of experiencing heartburn. This applies to both women and men. This extra weight increases your risk of heartburn for a number of reasons:

  • There is more pressure against your stomach.
  • With this increased pressure on the stomach, stomach contents may be pressing against the lower esophageal sphincter (LES).
  • If there is increased pressure against the LES, it may open when it shouldn't and allow stomach acid and other stomach contents to back up into the esophagus.

Foods That Trigger Heartburn

For many people, food is their biggest cause of heartburn. Some may attribute their heartburn to eating too much or eating that too spicy meal, but other foods can trigger heartburn, even when eaten in moderation. These foods may increase your chances of experiencing heartburn by either relaxing the LES or by stimulating acid production in the stomach. It is important to know which foods can cause heartburn, and which foods are most often safe for heartburn sufferers. However, each person is different, and what may trigger heartburn for one person may be okay for another to eat. Therefore, it's important to keep a heartburn diary for a week or two, keeping track of what foods you eat and whether or not heartburn occurred.

Some of the foods that can trigger heartburn include:

  • High-fat foods
  • Chocolate
  • Peppermint
  • Caffeinated beverages (e.g. soft drinks, coffee, tea, cocoa)
  • Carbonated beverages
  • Alcohol
  • Spicy foods
  • Black pepper
  • Citrus fruit and juices (e.g. orange, grapefruit)
  • Tomato juice

Mealtime Habits

Many people are in the habit of having three bigger meals and maybe a couple small snacks during the day. Unfortunately, this can be a bad habit if you suffer from heartburn. Eating large meals can increase the pressure in the stomach and also against the LES muscle. Eating five or six small meals instead of three larger ones is better. Drinking water will also aid in digestion.

Another good habit to get into is not eating too quickly. Putting your fork or spoon down between bites can help you eat slower. This allows your stomach to start digesting food while you are still eating, helping to keep your stomach from getting too full.

GERD

Heartburn and acid regurgitation are the main symptoms GERD, though some people have GERD without heartburn. Gastroesophageal reflux disease (GERD), also referred to as acid reflux disease, occurs when the LES does't close properly or opens when it shouldn't, causing the stomach contents to back up into the esophagus. Heartburn that occurs more than twice a week may be considered GERD, and it can eventually lead to more serious health problems. Your doctor will chart your symptoms, do a physical exam and may perform diagnostic tests, such as an upper endoscopy, before a diagnosis is made.

Hiatal Hernia

A hiatal hernia occurs when the upper part of the stomach pushes up into the chest through an opening in the diaphragm. There are two categories of hiatal hernias, sliding or para-esophageal.

Only about 50% of people with a hiatal hernia will experience any symptoms. However, in those who do, heartburn can be one of the symptoms of a hiatal hernia.

Smoking

Smoking can increase the odds of experiencing heartburn. Smoking can cause heartburn in a few ways, including a stimulation in the production of stomach acid, a weakening of the LES and slower digestion. In addition, smoking can injure the esophagus.

Alcohol

Alcohol can cause heartburn. The effects of alcohol include an increase in stomach acid production, a relaxing of the LES and making the esophagus more sensitive to stomach acid.

When Sleeping

Nearly 80% of heartburn sufferers will experience nighttime heartburn at least once. Heartburn can occur at night if you go to bed too soon after eating, especially if you have consumed a large meal. Heartburn may also occur if you lay flat, which allows stomach contents to press against the LES.

Exercise

Exercise is rarely the cause of heartburn if a person already doesn't suffer from chronic heartburn. Heartburn is more likely to occur during jarring exercises than during low-impact ones. There are a few things you can do to reduce the chances of heartburn during exercise, such as avoiding exercising shortly after you eat. Also, you should talk to your doctor first about which exercises may be best for you.

Stress

Many people who suffer frequent heartburn say a hectic lifestyle and work-related stress increase their heartburn. While stress hasn't been linked directly to heartburn, it is known that it can lead to behaviors that may trigger heartburn. When people go through stressful times, they may not follow their normal routines with meals, exercise and medication. It is important to find ways to alleviate the stress, and thus make stress-related heartburn less likely.

 

Sources:

American Journal of Gastroenterology, "Updated Guidelines for the diagnosis and Treatment of Gastroesophageal Reflux Disease." The American College of Gastroenterology..

Carol Ann Rinzler, Ken DeVault, MD. Heartburn & Reflux For Dummies. Wiley Publishing, Inc, 2004

"Heartburn and GERD FAQ." The American College of Gastroenterology, n.d. 17 Aug 2010. http://www.acg.gi.org/patients/gerd/faqansw.asp.

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